The therapy of diabetes
1979
Metabolic abnormalities of diabetes are explained. Evidence is given which supports the role of viral infection and autoimmune reactions in diabetes etiology. Recent developments have improved results of traditional insulin therapy. Recombinant-DNA technology has been used to produce human insulin. A mixture of somatostatin and insulin achieved greater blood-glucose stability than insulin alone. Studies on the role of weight reduction, carbohydrates, artificial sweeteners, dietary fiber, and the trace metals zinc and chromium have influenced present diet therapy. Research is being conducted on the feasibility of using mechnical or live-cell artificial endocrine pancreas to release insulin. Both require continuous intravenous connection, with risks of infection and clotting. Transplantation of the entire pancreas or islets of Langerhans has been attempted, but immunological rejection is a major problem. Autotransplantation has overcome rejection of islet transplants in rare cases. A recent breakthrough in pretreatment of transplants to make them less rejectable seems most promising.
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